Dataset Information

Periodontitis as the risk factor of chronic kidney disease: Mediation analysis.

ABSTRACT:

Aim

To determine sequences and magnitude of causality among periodontitis, diabetes and chronic kidney disease (CKD) by mediation analysis.

Methods

Ten-year-data were retrieved from the Electric Generation Authority of Thailand (EGAT) study. A cohort of 2,635 subjects was identified with no CKD at baseline. The interested outcome was CKD incidence defined as glomerular filtration rate <60 ml/min/1.73 m² . The percentage of proximal sites with clinical attachment loss ?5 mm was used to represent periodontitis. Mediation analysis with 1,000-replication bootstrapping was applied to two causal diagrams, diagram A (Periodontitis ? Diabetes ? CKD) and diagram B (Diabetes ? Periodontitis ? CKD).

Results

The cumulative incidence of CKD was 10.3 cases per 100 persons during 10-year period. In diagram A, each increasing percentage of proximal sites with severe periodontitis increased the adjusted odds ratio of CKD 1.010 (95% CI: 1.005, 1.015) and 1.007 (95% CI: 1.004, 1.013), by direct and indirect effect through diabetes, respectively. In diagram B, diabetes increased the odds of CKD twofold, with 6.5% of this effect mediated via periodontitis.

Conclusions

Periodontitis had significant direct effect, and indirect effect through diabetes, on the incidence of CKD. Awareness about systemic morbidities from periodontitis should be emphasized.

SUBMITTER: Lertpimonchai A

PROVIDER: S-EPMC6593715 | biostudies-literature | 2019 Jun

REPOSITORIES: biostudies-literature

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Publications

Periodontitis as the risk factor of chronic kidney disease: Mediation analysis.

Lertpimonchai Attawood A Rattanasiri Sasivimol S Tamsailom Suphot S Champaiboon Chantrakorn C Ingsathit Atiporn A Kitiyakara Chagriya C Limpianunchai Anusorn A Attia John J Sritara Piyamitr P Thakkinstian Ammarin A

Journal of clinical periodontology 20190601 6

<h4>Aim</h4>To determine sequences and magnitude of causality among periodontitis, diabetes and chronic kidney disease (CKD) by mediation analysis.<h4>Methods</h4>Ten-year-data were retrieved from the Electric Generation Authority of Thailand (EGAT) study. A cohort of 2,635 subjects was identified with no CKD at baseline. The interested outcome was CKD incidence defined as glomerular filtration rate <60 ml/min/1.73 m<sup>2</sup> . The percentage of proximal sites with clinical attachment loss ≥5 ...[more]

PMID: 30993705

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Project description:MethodsCardiovascular risk factors, aortic and cardiac function, atherosclerosis extent, and cardiovascular event rates were assessed in 115 consecutive predialysis (n = 67) and dialysis patients (n = 48) including 46 black and 69 other (32 Asian, 28 white, and 9 mixed race) participants. Data were analysed in multivariable regression models.ResultsOverall, black compared to other African CKD patients had less frequent carotid artery plaque (OR (95% CI) = 0.38 (0.16-0.91)) despite an increased cardiovascular risk factor burden. In receiver operator characteristic curve analysis, the Framingham score performed well in identifying non-black but not black CKD patients with carotid plaque (area under the curve (AUC) (95% CI) = 0.818 (0.714-0.921) and AUC (95% CI) = 0.556 (0.375-0.921), respectively). Black compared to other African predialysis patients experienced larger Framingham scores and more adverse nontraditional cardiovascular risk factors, impaired arterial and diastolic function but similar cardiovascular event rates (OR (95% CI) = 0.93 (0.22 to 3.87)). Among dialysis patients, black compared to other Africans had an overall similar traditional and nontraditional cardiovascular risk factor burden, similar arterial and diastolic function but increased systolic function (partial R = 0.356, p = 0.01 and partial R = 0.315, p = 0.03 for ejection fraction and stroke volume, respectively) and reduced cardiovascular event rates (OR (95% CI) = 0.22 (0.05 to 0.88)).ConclusionBlack compared to other African CKD patients have less frequent very high risk atherosclerosis and experience weaker cardiovascular risk factor-atherosclerotic CVD relationships. These disparities may be due to differences in epidemiological health transition stages. Among dialysis patients, black compared to other Africans have less cardiovascular events, which may represent a selection bias as previously documented in black Americans.

Dataset Information

Periodontitis as the risk factor of chronic kidney disease: Mediation analysis.

Aim

Methods

Results

Conclusions

Publications

Periodontitis as the risk factor of chronic kidney disease: Mediation analysis.

Similar Datasets

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